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Journal of Cancer Survivorship

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Open Access 13-09-2021

Predicting physical activity change in cancer survivors: an application of the Health Action Process Approach

Authors: Sarah J. Hardcastle, Chloe Maxwell-Smith, Martin S. Hagger

Published in: Journal of Cancer Survivorship | Issue 6/2022

Abstract

Purpose

Previous research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors.

Methods

Participants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables.

Results

Consistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistically significant predictors of intention change over time. Changes in intention (β = 0.217, p = 0.029, ES = 0.040) and action planning (β = 0.234, p = 0.068, ES = 0.068) predicted changes in MVPA. Overall, the model accounted for significant variance in intention (R² = 0.380) and MVPA (R² = 0.228) change.

Conclusions

Changes in intention and action planning were important correlates of MVPA change over 24 weeks. Further, changes in action self-efficacy and risk perceptions predicted changes in intention. Implications for cancer survivors: interventions that foster risk perceptions and self-efficacy, strengthen intentions, and promote action planning may be effective in promoting sustained PA change in cancer survivors.

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Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23:8884–93.CrossRefPubMed

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA-Cancer J Clin. 2011;61:69–90.CrossRefPubMed

Rowland JH. What are cancer survivors telling us? Cancer J. 2008;14:361–8.CrossRefPubMed

Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005;23:5814–30.CrossRefPubMed

Keats MR, Cui Y, Grandy SA, Parker L. Cardiovascular disease and physical activity in adult cancer survivors: a nested retrospective study from the Atlantic PATH cohort. J Cancer Surviv. 2016. https://doi.org/10.1007/s11764-016-0584.CrossRefPubMed

Brown JC, Gilmore LA. Physical activity reduces the risk of recurrence and mortality in cancer patients. Exerc Sport Sci Rev. 2020;48:67–73.CrossRefPubMedPubMedCentral

Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:242–74.CrossRef

Hirschey R, Bryant AL, Macek C, et al. Predicting physical activity among cancer survivors: metaanalytic path modeling of longitudinal studies. Health Psychol. 2020;39(4):269–80.CrossRefPubMedPubMedCentral

McEwan D, Beauchamp MR, Kouvousis C, Ray CM, Wyrough A, Rhodes RE. Examining the active ingredients of physical activity interventions underpinned by theory versus no stated theory: a meta-analysis. Health Psychol Rev. 2019;13:1–17. https://doi.org/10.1080/17437199.2018.1547120.CrossRefPubMed

10.

Bluethmann S, Barthlolemew LK, Murphy CC, Vernon SW. Use of theory in behavior change interventions: an analysis of programs to increase physical activity in posttreatment breast cancer survivors. Health Educ Behav. 2017;44(2):245–53.CrossRefPubMed

11.

Sheeran P, Webb TL. The intention–behavior gap. Soc Pers Psychol Compass. 2016;10(9):503–18. https://doi.org/10.1111/spc3.12265.CrossRef

12.

Schwarzer R, Luszczynska A. How to overcome health compromising behaviors: the health action process approach. Eur Psychol. 2008;13:141–51. https://doi.org/10.1027/1016-9040.13.2.141.CrossRef

13.

Zhang C, Zhang R, Schwarzer R, Hagger MS. A meta-analysis of the health action process approach. Health Psychol. 2019;38(7):623–37.CrossRefPubMed

14.

Paxton RJ. The health action process approach applied to African American breast cancer survivors. Psychooncology. 2016;25(6):648–55. https://doi.org/10.1002/pon.3866.CrossRefPubMed

15.

Maxwell-Smith C, Cohen PA, Platell C, et al. Wearable activity technology and action-planning (WATAAP) to promote physical activity in cancer survivors: randomised controlled trial protocol. Int J Clin Health Psychol. 2018;18:124–32. https://doi.org/10.1016/j.ijchp.2018.03.003.CrossRefPubMedPubMedCentral

16.

Maxwell-Smith C, Hince D, Cohen P, et al. A randomized controlled trial of WATAAP to promote physical activity in colorectal and endometrial cancer survivors. Psychooncology. 2019;28(7):1420–9.CrossRefPubMed

17.

Freedson PS, Melanson E, Sirard J. Calibration of the computer science and applications, inc. accelerometer. Med Sci Sports Exerc. 1998;30(5):777–81. https://doi.org/10.1097/00005768-199805000-00021.CrossRefPubMed

18.

Parschau L, Barz M, Richert J, Knoll N, Lippke S, Schwarzer R. Physical activity among adults with obesity: testing the health action process approach. Rehabil Psychol. 2014;59:42–9. https://doi.org/10.1037/a0035290.CrossRefPubMed

19.

Hardcastle SJ, Glassey R, Salfinger S, Tan J, Cohen P. Factors influencing participation in health behaviors in endometrial cancer survivors. Psychooncology. 2017;26:1099–104. https://doi.org/10.1002/pon.4288.CrossRefPubMed

20.

Maxwell-Smith C, Zeps N, Hagger MS, Platell C, Hardcastle SJ. Barriers to physical activity participation in colorectal cancer survivors at high risk of cardiovascular disease. Psychooncology. 2017;26:808–14. https://doi.org/10.1002/pon.4234.CrossRefPubMed

21.

Short CE, James EL, Girgis A, Mcelduff P, Plotnikoff RC. Move more for life: the protocol for a randomised efficacy trial of a tailored-print physical activity intervention for post-treatment breast cancer survivors. BMC Cancer. 2012;12:172–81. https://doi.org/10.1186/1471-2407-12-172.CrossRefPubMedPubMedCentral

22.

Graham SP, Prapavessis H, Cameron LD. Colon cancer information as a source of exercise motivation. Psychol Health. 2006;21:739–55. https://doi.org/10.1080/14768320600603554.CrossRef

23.

Plotnikoff RC, Blanchard CM, Hotz SB, Rhodes RE. Validation of the decisional balance scales in the exercise domain from the transtheoretical model: a longitudinal test. Meas Phys Educ Exerc Sci. 2001;5:191–206. https://doi.org/10.1207/S15327841MPEE050401.CrossRef

24.

Rogers LQ, Shah P, Dunnington G, Greive A, Shanmugham A, Dawson B, Courneya KS. Social cognitive theory and physical activity during breast cancer treatment. Oncol Nurs Forum. 2005;32:807–15. https://doi.org/10.1188/05.ONF.807-815.CrossRefPubMed

25.

Rhodes RE, Blanchard CM, Matheson DH, Coble J. Disentangling motivation, intention, and planning in the physical activity domain. Psychol Sport Exerc. 2006;7:15–27. https://doi.org/10.1016/j.psychsport.2005.08.011.CrossRef

26.

Ajzen I, Brown TC, Carvajal F. Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation. Pers Soc Psychol Bull. 2004;30:1108–21.CrossRefPubMed

27.

Kock N. WarpPLS User Manual: Version 7.0. Laredo, Texas: ScriptWarp Systems™; 2020.

28.

Tenenhaus M, Vinzi VE, Chatelin YM, Lauro C. PLS path modeling. Comput Stat Data Anal. 2005;48:159–205.CrossRef

29.

Hagger MS, Hardcastle SJ, Hingley C, Strickland E, Pang J, Watts GF. Predicting self-management behaviors in familial hypercholesterolemia using an integrated theoretical model: the impact of beliefs about illnesses and beliefs about behaviors. Int J Behav Med. 2016;23:282–94.CrossRefPubMed

30.

Barg CJ, Latimer AE, Pomery EA, Rivers SE, Rench TA, Prapavessis H, Salovey P. Examining predictors of physical activity among inactive middle-aged women: an application of the health action process approach. Psychol Health. 2012;27:829–45. https://doi.org/10.1080/08870446.2011.609595.CrossRefPubMed

31.

McEachan R, Taylor N, Harrison R, Lawton R, Gardner P, Conner M. Meta-analysis of the reasoned action approach (RAA) to understanding health behaviors. Ann Behav Med. 2016;50:592–612. https://doi.org/10.1007/s12160-016-979.CrossRefPubMed

32.

Conner M, Norman P. Predicting and changing health behaviour: research and practice with social cognition models. Maidenhead: McGraw-Hill Education, Open University Press; 2015.

33.

Maxwell-Smith C, Hagger MS, Kane R, … Hardcastle SJ. Psychological correlates of physical activity and exercise preferences in metropolitan and nonmetropolitan cancer survivors. Psycho-Oncology. 2021;30(2):221–230.

34.

Rhodes RE, de Bruijn GJ. How big is the physical activity intention-behaviour gap? A meta-analysis using the action control framework. Br J Health Psychol. 2013;18(2):296–309. https://doi.org/10.1111/bjhp.12032.CrossRefPubMed

35.

Bélanger-Gravel A, Godin G, Amireault S. A meta-analytic review of the effect of implementation intentions on physical activity. Health Psychol Rev. 2013;7(1):23–54. https://doi.org/10.1080/17437199.2011.560095.CrossRef

36.

Lippke S, Plotnikoff RC. Testing two principles of the health action process approach in individuals with type 2 diabetes. Health Psychol. 2014;33:77–84.CrossRefPubMed

37.

Fischer X, Donath L, Zahner L, Faude O, Gerber M. Exploring psychosocial mediators of remote physical activity counselling: a secondary analysis of data from a 1-year randomised control trial (MovingCall). J Beh Med. 2020;43(2):271–83.CrossRef

38.

Scholz U, Sniehotta FF, Schwarzer R. Predicting physical exercise in cardiac rehabilitation: the role of phase-specific self-efficacy beliefs. J Sport Exerc Psychol. 2005;27:135–51.CrossRef

39.

Renner B, Spivak Y, Kwon S, Schwarzer R. Does age make a difference? Predicting physical activity of South Koreans. Psychol Aging. 2007;22:482–93. https://doi.org/10.1037/0882-7974.22.3.482.CrossRefPubMed

40.

Schwarzer R, Schuz B, Ziegelmann JP, Lippke S, Luszczynska A, Scholz U. Adoption and maintenance of four health behaviors: theory-guided longitudinal studies on dental flossing, seat belt use, dietary behavior, and physical activity. Ann Behav Med. 2007;33:156–66. https://doi.org/10.1007/BF02879897.CrossRefPubMed

Title: Predicting physical activity change in cancer survivors: an application of the Health Action Process Approach
Authors: Sarah J. Hardcastle
Chloe Maxwell-Smith
Martin S. Hagger
Publication date: 13-09-2021
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 6/2022
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-021-01107-6

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Abstract

Purpose

Methods

Results

Conclusions

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